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BMC Musculoskeletal Disorders

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Open Access 01-12-2021 | Research article

Midterm outcome after posterior stabilization of unstable Midthoracic spine fractures in the elderly

Authors: U. J. Spiegl, P.-L. Hölbing, J.-S. Jarvers, N. v. d. Höh, P. Pieroh, G. Osterhoff, C.-E. Heyde

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

The evidence for the treatment of midthoracic fractures in elderly patients is weak. The aim of this study was to evaluate midterm results after posterior stabilization of unstable midthoracic fractures in the elderly.

Methods

Retrospectively, all patients aged ≥65 suffering from an acute unstable midthoracic fracture treated with posterior stabilization were included. Trauma mechanism, ASA score, concomitant injuries, ODI score and radiographic loss of reduction were evaluated. Posterior stabilization strategy was divided into short-segmental stabilization and long-segmental stabilization.

Results

Fifty-nine patients (76.9 ± 6.3 years; 51% female) were included. The fracture was caused by a low-energy trauma mechanism in 22 patients (35.6%). Twenty-one patients died during the follow-up period (35.6%). Remaining patients (n = 38) were followed up after a mean of 60 months. Patients who died were significantly older (p = 0.01) and had significantly higher ASA scores (p = 0.02). Adjacent thoracic cage fractures had no effect on mortality or outcome scores. A total of 12 sequential vertebral fractures occurred (35.3%). The mean ODI at the latest follow up was 31.3 ± 24.7, the mean regional sagittal loss of reduction was 5.1° (± 4.0). Patients treated with long segmental stabilization had a significantly lower rate of sequential vertebral fractures during follow-up (p = 0.03).

Conclusion

Unstable fractures of the midthoracic spine are associated with high rates of thoracic cage injuries. The mortality rate was rather high. The majority of the survivors had minimal to moderate disabilities. Thereby, patients treated with long segmental stabilization had a significantly lower rate of sequential vertebral body fractures during follow-up.

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Title: Midterm outcome after posterior stabilization of unstable Midthoracic spine fractures in the elderly
Authors: U. J. Spiegl
P.-L. Hölbing
J.-S. Jarvers
N. v. d. Höh
P. Pieroh
G. Osterhoff
C.-E. Heyde
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-04049-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Midterm outcome after posterior stabilization of unstable Midthoracic spine fractures in the elderly

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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